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Development of the Heart 212 – 2004 – Week 6 Avinash Bharadwaj Retrospect… Trilaminar embryo Three germ layers Head and tail folds Cardiovascular System The Heart Blood vessels Abnormal development Correlation Some Special Features Early development and function Requirements of the foetus Non-functional lungs Placental circulation Planning for postnatal life Right-left passage essential during foetal life, obliteration required immediately after birth. The phylogenetic sequence. Earliest Development Angiogenic cell clusters or Blood Islands Blood cells and endothelium Cardiogenic Area Flat embryo Position of cardiogenic area Head Fold Cardiac area Gut formation Pericardium and heart tube Later… The Heart Tube Venous and arterial ends Regions defined Bulbus cordis Ventricle Atrium Sinus venosus Conus and Truncus…? The Tube Bends V B D A V SV The Chambers A A A V BVL Left Front The Interior A-Ar R and L atria Atrioventricular canal : common Outflow Aortic arches LA RA AVC Left – Right Partitioning Interatrial septum Interventricular septum Spiral (aortico-pulomonary septum Endocardial cushions (A-V cushions) Functional requirements There must always be a right to left passage! Interatrial septum Partitioning Right to left passage Mechanism for closing the passage A V Septum Primum AVC V This is a sagittal section seen from the right. Foramen Primum Foramen primum : Between the septum and the AV Cushions Passage is a Must! Foramen secundum Foramen primum about to disappear Septum Secundum To the right of primum Foramen primum has disappeared Foramen ovale F. Ovale – In septum secundum Further… The ‘Valve’ Two septa Two foramina Sinus Venosus Originally a symmetrical structure Right and left “horns” Venous return more to the right Left horn becomes smaller Opening shifts to the right Later – part of right atrium Left Atrium Four pulmonary veins Common opening “Absorption” of veins into atrium Rough part - auricle The Ventricular Septum Three Parts Interventricular septum AV Cushions Spiral Septum The Ventricular Septum R Membranous Muscular Spiral (Aorticopulmonary) Foetal Circulation Very little pulmonary flow Placental Circulation Right to Left Passages IVC : Blood from placenta Ductus venosus F. ovale Ductus arteriosus Changes At Birth Closure of interatrial septum Closure of ductus arteriosus Closure of ductus venosus Congenital Heart Disease Septal Defects – Atrial and Ventricular Endocardial cushion defects Aorticopulmonary defects PDA Others